Program Officer for Mental Health and Rights at the Open Society Foundations, New York, USA, Research Associate, Harvard Law School Project on Disability and Visiting Research Fellow at the Centre for Applied Legal Studies, University of the Witwatersrand, Johannesburg, South Africa.
Health Hum Rights. 2020 Jun;22(1):35-49.
Throughout the world, mental health remains a neglected priority, low on the agenda of policy makers and funders at the national and international levels. While this is shifting somewhat, there remains a considerable need to address the underprioritization of mental health and well-being, perhaps even more so in the wake of the COVID-19 pandemic. However, given the history of mental health interventions-which have overemphasized the biomedical model and have thus resulted in coercion, denial of life in the community, and unnecessary pathologization of human experience-there is also a need to ensure that increased funding does not simply replicate these mistakes. This is particularly true in the current landscape, where efforts to "scale up" mental health and to reduce "treatment gaps" are gaining momentum and where post-pandemic responses are still being formulated. As the potential for global mechanisms for funding mental health increases, national and international funders should look to practices that are rights affirming and contextually relevant. In this paper, I explore the current landscape of mental health financing, in terms of both national resource allocation and development assistance. I then outline the momentum in global mental health that is likely to materialize through increased funding, before considering ways in which that funding might be utilized in a manner that promotes human rights.
在全球范围内,精神卫生仍然是一个被忽视的优先事项,在国家和国际层面的政策制定者和资助者的议程上排名靠后。虽然这种情况正在有所改变,但仍有相当大的需要解决精神卫生和福祉被优先重视不足的问题,尤其是在 COVID-19 大流行之后。然而,鉴于精神卫生干预措施的历史-这些干预措施过分强调生物医学模式,从而导致了强制、社区生活的剥夺和对人类经验的不必要病理化-也有必要确保增加的资金不会简单地重复这些错误。在当前的情况下尤其如此,因为"扩大"精神卫生和减少"治疗差距"的努力正在获得动力,而大流行后的应对措施仍在制定中。随着全球精神卫生筹资机制的潜力增加,国家和国际资助者应该寻求肯定权利和与背景相关的做法。在本文中,我探讨了精神卫生筹资的现状,包括国家资源分配和发展援助。然后,我概述了可能通过增加资金实现的全球精神卫生方面的势头,然后考虑如何以促进人权的方式利用这些资金。